Susan Orenstein’s Approach to Couples Counseling

When couples come to see me, they often consider conflict a dirty word. They think it refers to critical, destructive or hurtful behavior. The truth is, conflict, when handled respectfully, is an opportunity for couples to grow, feel more connected and learn more about one another.

Each couple walking through my doors is going through something different. Common issues that bring couples to counseling include:

–       Premarital concerns

–       Major life adjustment, such as a new baby, diagnosis, empty nest, retirement

–       Betrayal or affair

–       Sexual intimacy issues

–       Blended Families

Maybe you’re currently going through a variety of these issues. Regardless of the stage of your relationship, I work collaboratively with couples using an approach known as PACT (the Psychobiological Approach to Couples Therapy). Without getting too deep in the jargon, the basic tenant of PACT is identifying your verbal and non-verbal communication styles and getting your hopes and desires met.

With PACT, I help you understand the meaning behind your partner’s words and vice versa, rather than responding to what’s on the surface. Couples counseling allow you both to learn how to communicate more effectively, listen intently and work as a team to resolve conflicts and develop a deeper understanding of one another.

Beginning on day one, we work to identify your relationship strengths as well as areas that require improvement. The long-term goal is for each person is to feel safe and loved and able to express and listen without judgment. That’s the hallmark of true intimacy.

In my practice, I see my couples together in session. My overall goal as your couples therapist is to affect change within the couple dynamic. With all of us together in the room, no one should feel like any of us are withholding information. Each person needs to present in order to become more conscious of your interactions and attuned to each other.

In my experience, one of the biggest relationship difficulties couples experience is expressing vulnerability. When people feel like their needs are not getting met, their behaviors tend to be overly dismissive or reactive. My job is to highlight sensitive issues, coach you on how to listen non-defensively and find common solutions. This is an active process that happens in real time. As a couple, you display your dynamic, and I provide direction and adjustments that help resolve your unique conflicts.

With the right guidance and support, it’s possible to become more confident in your ability to navigate differences and support each other. In our sessions, you can learn through direct experience what it feels like to be heard, repair hurts and get your needs met.

There will always be conflict and misunderstandings in relationships. However, your ability to come back together defines your strength and bond as a couple. When you’re provided with the tools to notice your partner’s hurts and ways to provide relief, the small disagreements don’t grow into big resentments.

As part of this process, we set ground rules and a game plan about how you can continually collaborate with, respect and honor one another. When relationship therapy ends, you both should feel more connected and empowered. Each couple should walk away with practical skills to communicate and manage stress. Wouldn’t you like to laugh and play together, enjoy sexual intimacy and feel unified in your shared dream again?

If you’re ready to truly understand and connect with your partner,


DEC 1, 2021

Please note that as of December 1st, 2021, 
our new office is located inside of Regus office suites at:

9121 Anson Way, Suite 200, Raleigh, NC 27615

Click here for directions.

COVID-19: Some of our clinicians have resumed in-person appointments while others continue to offer online-only services. Visit the “Our Team” page for more information.

Ready to get started?


Get answers to your questions and set up an appointment online or over the phone.  

GIVE US A CALL: 919-428-2766

Our office manager is available by phone from 9:00 am to 1:00pm. Calls received after 1:00 pm will be returned the following business day.